Tuesday, May 31, 2005

Age-Old Quest

Last night the bathwater was discolored because we'd been away for the long weekend, and the rust had built up in the pipes. Cassie was dubious at first about getting in, but was finally convinced it was all right. It wasn't long after that that the brownish-yellow tint inspired a new game: as she busily poured the water from cup to bucket and stuffed her washcloth into the honey bear, Cassie told me that she was "making golden metal."

"Oh!" I said. "Did you know that there's a word for that? It's called alchemy."

"I don't call it alchemy," she replied. "I don't call it alchemy. I don't call it alchemy because that's not a good name for it."

Um, well, okay. That shut me up, didn't it? Cassie worked a little more, then confided more of her process:

"I'm adding in some plastic, to make it more comfortable."

Wednesday, May 25, 2005

Pop

This past week, our little class of returning nurses went to Other Famous Hospital (which is to say, the same illustrious institution where my dad was hospitalized for two weeks last fall) for our initial orientation to our clinical placements. Tucked around a conference table in a claustrophobic room on the first floor of one of the more historical buildings in the medical center, we listened as a preppy blond woman walked us through a packet of hand-outs. Afterwards, she led us to a basement office to get our temporary IDs and then to a 10th floor office to fill out computer access paperwork. Finally, she gave us a bit of a tour. It's a vast place--multiple connected buildings, a zillion floors--and I actually was kind of glad to know my way around a little bit already (even if some of the memories stirred by the various locations made my chest clench). I think I would have been utterly overwhelmed if I were seeing it all for the first time. We walked around quite a bit, got oriented to cafeterias and cafes didn't really do more than look at the actual clinical units they're assigning us to. My understanding is that they haven't yet finished lining up all the preceptors.

This whole program, we students have privately agreed, seems pretty loosey-goosey in a lot of respects. We get information in dribs and drabs, and still don't know when our clinicals will actually start. What's funny is that from what we can tell, this is actually the tightest-run program of its kind in our area, though it does sort of make sense. There are no particular certification requirements for nurses returning to practice--we have RN licenses, and anything beyond that is at our own discretion (and that of our prospective employers). If a hospital wanted to hire a nurse who hadn't touched a patient in 20 years, they legally could, so long as she had kept her license active (in most states that requires documentation of a certain number of continuing education hours plus writing a nice little check every couple years; in some states, though, you only need the check). So there aren't any mandates or even guidelines for nurse refresher programs to follow.

Anyway, a couple of class sessions ago, our primary instructor announced that they'd already had a request for a returning nurse/student from our program from one unit that had never participated before--would any of us be interested in doing oncology? Everybody else made "uh-uh, not me" kinds of noises, while I felt a sensation in my mind that was kind of like a little *pop* . The sound of a piece fitting into place, I guess, or maybe of a membrane breaking. I want to do oncology. Oh my goodness, of course. I hadn't known, and then she asked, and then I knew, just like that. I didn't want to be too quick and greedy, in case my classmates would think I was pushy, and what if somebody suddenly realized that it was the perfect thing and I stole it from them, but as soon as a small but decent interval had passed, I raised up my little hand and said, um, yes, I would.

And ever since then, I've felt actual, positive anticipation of getting started. When I was assuming I was going to be doing general med-surg, I was kind of looking forward to getting started, at least in a let's-get-the-show-on-the-road kind of way, but it also was looking like a very long spinach-liver-7th-grade-gym kind of experience. Good for me and humiliating in approximately equal measure. But thinking about doing oncology, I guess it's that I feel like I, personally, actually have something to offer. It's not just something I'm doing to have done it, to pay my dues and learn my lessons and make my nursing career grow big and strong, all while sucking at it in a major funny-pathetic way. Oncology seems like a place I might actually belong, where who I am might be as much a help as a hindrance. Even if I still suck at fitting everything I have to do into a shift, and I'm raw-green-new at a lot of procedures, and don't know my [patient's] ass from my [her] elbow in physical assessment, it still changes the whole gestalt. Pain, suffering, fear, joy, presence, uncertainty, life, death. That I can do.

And meanwhile, in class, I've been learning or relearning all kinds of good and useful stuff, which has been heartening and kind of exciting in itself. Interpreting arterial blood gases, which kinds of IV fluids you use in which situations, heart murmurs and split S2 vs. S3 vs. S4, what a pleural friction rub sounds like. Today we had an amazingly good lecture on wound care, and the lady who gave it (a PhD nurse) actually works at Other Famous Hospital, and invited us to give her a call if we ever have questions while we're on the floor.

I kind of could go on and on, but I've been trying for 5 days now to finish this one measly post, and I need to go to bed now. The beauty of the blog is that tomorrow is another day.

Friday, May 20, 2005

Let It Snow

As I think I might have mentioned once or twice, Prozac agrees with me. (Well, generic fluoxetine does, anyway, if we're going to get technical.) I have developed an almost anthropomorphizing affection and gratitude for those dear little white ovals which, taken two at bedtime, all but eliminate my hair-trigger squirts of dread, while making my lows less low, my difficulties less difficult, my obstacles less obstacular. I know that some people have prohibitively unpleasant side-effects with this particular medication, but since my initial nausea and yuckiness during the run-in period, I have had almost nothing besides the mood elevation.

Almost nothing. The one side-effect that seems to be sticking around is this thing that it does to my dreams. I hesitate to say that it makes them more vivid, though that might in fact be accurate, because to me somehow the connotations of "vivid dreams" include garish colors and, I don't know, talking circus sea slugs or something. And what I'm getting instead is just night after night of these busy, detailed, absorbing alternate worlds. No electric blue singing molluscs, just a lot of the usual reality-based dream fare (heavy on high school and college graduations and reunions lately) but somehow kicked up a notch, and with a sensation, on awakening, of simply trading realities, that one for this.

As usual, my college friend Nora and my high school boyfriend figure fairly prominently in the cast of characters (whatever they represent to my psyche, it's clearly pretty central--they're always showing up in my head during REM). And then there are other friends and family members showing up here and there, occasional guest appearances by random famous people (most recently, the actor Jon Cryer), and lots of fully developed characters with faces and personalities and palpable essences but whom I've never met or seen in waking life.

A few nights ago, my dreams featured a starring role for a college classmate, the famous Lisa Chun. Well, she was famous in our class, anyway, and I daresay in years just above and just behind us. My senior-year girlfriend and her housemate used to roll their eyes and call her "the Wayne Newton of [our college's name here] lesbians," but I am here to tell you she was really the Elvis of [our college's name here] lesbians--you could argue that maybe she was a little sleazy, but her charisma was undeniably real. My little circle of friends were definitely outside the highest status clique (we called them the Cool Smoking Lesbians), but you know, it just wasn't that big a school, so we went to the same parties. Besides which, a cat may look at a king. I am not embarrassed to tell you (okay, maybe I'm a little embarrassed) that Lisa Chun made my knees weak. I suppose that it was a kind of cheeky acknowledgement of Lisa Chun's legend-in-her-own-time status that my friends and I had a whole repertoire of songs (show tunes, Christmas carols, jazz standards) reworded to include her name. Our "Some Enchanted Evening" was probably the most fun to sing, but I find that it's our "Let It Snow" that's been playing in my head a lot recently.

Anyway, the dream itself wasn't all that interesting. It involved some prank or otherwise slightly illicit mission, and we were climbing up gray metal ladders through a multi-story empty warehouse. There was something about various cans of colored paint up on the gravelly roof. I suppose if you were really intent on finding repressed sexuality in there, you could do it, but I'm a little dubious about the Freudian reading. Or maybe I just don't want to believe it, since by the end, Lisa Chun had more or less morphed into Angelina Jolie, who just plain gives me the willies. Be that as it may, since having the dream about Lisa Chun (and especially in the day or two afterwards, when I had that strange feeling of actually having seen her recently--you know how dreams can conjure so completely the feeling of someone, the smell of their personality?), I've been thinking about the phenomenon of bigger-than-life-ness.

The last time I actually did see Lisa Chun was at our 10th year college reunion. I had a weird twin reaction to her. Her lofty stature had to be diminished--she'd gained quite a bit of weight and therefore couldn't help but look kind of cushiony and motherly rather than just effortlessly cool-butch, and she was working in some desperately unglamorous place, like an insurance company or an HMO, while a lot of our classmates were truly in the thick of the fabulous careers we were all supposed to have. But at the same time, the feeling was stubbornly the same. I still couldn't really see her as an actual person. I still did an abominable job of making small talk with her, although I'd been happily and volubly catching up with everybody else, including a friend of hers and fellow-Cool-Smoking-Lesbian (who'd gone to nursing school and become a nurse practitioner, so we had a lot to talk about). I truly could barely be civil, I got so flustered and tongue-tied. I mean, it was really ridiculous. And the excruciating thing was (and is), I know she could tell. She seemed to find it a little bit entertaining. But then the dancing started, and I wasn't really having much of a conversation with anyone, because I'm most basically a dancing fool, and the awkwardness goes away because I'm just so happy to be dancing.

It was toward the end of the party, then, and just a few more songs before we were all going to head off into the night, and there was a bit of dead air as somebody changed the tape on the boom-box. Then, as the music was starting again, Lisa Chun herself came up to me and took my hand and wordlessly led me out onto the floor. And so this was my brush with greatness--a slow dance with the Elvis of [unnamed college] lesbians. I wish I could tell you what it was like, or how I felt, or even what song was playing, but it's frustratingly blank in my memory. I suppose it wasn't really so eventful, when it comes right down to it. But then, at the end of the dance, she stepped back slightly and, confidently and deliberately, kissed me.

Lisa Chun is an exceedingly good kisser. The fact that this was entirely to be expected given her reputation somehow had not occurred to me, and the revelation carried for me the kind of narrative satisfaction that a nice twist ending gives (The Usual Suspects, say, or the season finale of Veronica Mars). It was perfect.

But it brings us back to an individual person having such iconic status that even in the fleshy flesh, the glamor is not dispelled, and the human being, with worries and interests and insecurities and neuroses and quirky habits and habitual blind spots and overused phrases and occasional intestinal gurgles and favorite television programs, is not revealed. How can that be? I suppose that in this case, it's not really so inexplicable. There I was, back at the scene of my postadolescent awkwardnesses and struggles, with those self-same people, and there was Lisa Chun, in her element, in a relatively controllable situation that played to her strengths.

But it undermines my sense of myself as someone who sees people as people, someone who is uncowed by status or other external trappings. My mother, after all, years ago when she was still a very junior employee, used to call her company's vice presidents "Cherry Pie," and I'm my mother's daughter. I sweetly ask the tough-guy gang-banger types on the bus to scoot over so I can sit down. I cheerfully and easily said good morning to the president of the hospital where I worked, and nonplussed the CEO of the last company where I temped by utterly failing to quake when he bellowed at me. So it bugs me that I'm not impervious, that Lisa Chun (or anyone) can strike me dumb (in both senses of the word), can scatter my thoughts and make me stammer and make me forget that people are always just people.

At the same time, though, I feel a little nostalgia for that feeling. It's exhilarating to be subject to the force of a charismatic presence. (My mom and her best friend have a word for that not-necessarily-good-for-you kind of infatuation: cocaine. It seems very apt--a white-hot, ice-cold rush that clears out your sinuses and makes your heart race, and ultimately just makes you crave more.) It's also reassuring, I suspect, to believe in the existence of inaccessible realms, to crave acceptance into a club that would not have us as a member. "Man's reach must exceed his grasp, or what's a heaven for." How drab and dreary if this is all there is. And how crushing the responsibility if the we are all the world has to see it through. How much nicer if there are enchanted and superior creatures out there we can defer to, look to, pretend we aspire to but never really expect to attain kinship with.

And so if we don't have a Lisa Chung or her equivalent in our immediate environment, we can turn to movie stars and rock musicians, famous writers and nationally known politicians, for our fix. Could I keep my head in a room with Barack Obama or Laurie Anderson or Nicole Kidman or David Sedaris? Almost surely not. Celebrity provides that same exciting and deliciously disempowering sensation if you encounter it.

It's actually one of the things I like best about nursing that it pulls in just about exactly the opposite direction. The commonality of people, not just as people, but even more prosaically and concretely as biological entities, is essential to nursing practice. The wretched, homely realities of daily existence as mammals on planet Earth--belching, farting, salivating, peeing, eating, shitting, coughing, breathing, sleeping--which in social interactions we either strenuously domesticate or out-and-out deny, are accepted and seen with the utmost in matter-of-fact interest by working nurses. Assessing those very things is a straightforward and un-charged part of the job. People are people, and we're all in this mess of a life together. I'm glad to be part of a profession where that's how I get to spend most of my time. Even if I can't help but remain susceptible in small spots to wicked glamor.

Thursday, May 19, 2005

Boo

You know, I generally don't approve of calling older people "cute." It seems patronizing and disrespectful. But oh, gosh, sometimes the shoe really, really fits.

I'm entering "event reports" at my temp job, and there's one I kind of have to share with you. It's a report of a patient fall. The elderly man's wife usually makes sure that he's in bed before she goes to bed herself, but on this night, he wants to stay up late to watch a TV program about ghosts. After a bit, she's concerned, so she heads out of the bedroom to check on him, just as he's coming in. He's so startled he loses his balance and falls over backwards. (He is not hurt, which means we get to find this funny and endearing if we want to.)

Then, of course, there's the one where the husband of the woman suffering debilitating depression intentionally gives her a 4-fold dose of her sedative-hypnotic, then tells the nurse on the phone that no visit is necessary because his wife is too tired. Um. Less funny, less endearing. (She, too, was okay, incidentally.)

Monday, May 16, 2005

Tired

I kind of don't think about it a lot these days, I guess because it makes me sad and mad and tired, and it's nicer just to forget about it, but a defining feature of my 20s was Chronic Fatigue Syndrome. Well, to be accurate, I never really fit the CDC definition of CFS, which includes something like "reduction in activity by at least 50%," and I'd guess my activity was actually only reduced by about 25%. Of course, in order to maintain that remaining 75%, I gritted my teeth and forced myself to do stuff that needed doing (hold a job, do laundry, go grocery shopping) despite feeling like holy hell and wanting so, so badly to lie down. It felt kind of like the very first day of a cold, you know? That day of feeling achy and sick, sore-throated and slightly feverish, and terribly run down, before the rest of the cold kicks in, and your nose starts doing its faucet impression. Only instead of lasting a day (or two), it lasted for 6-9 months at a time.

....

Okay, now it's nearly 2 weeks later. Yikes. My point was going to be that I've been having a small flare-up just now, and it's making everything harder. So, ah, there you go. Case in point.

Actually, my not writing has also had to do with how much I find I have to say about the experience of CFS, some of it still kind of inchoate and/or bound up in grief and anger. So I suppose I've been waiting for that golden chunk of time--you know, that magical unencumbered 5-hour interval that's going to pop up any moment now, when I can really sit and write it all out. And my life being rather short on magical unencumbered spans of 5 hours lately, I've been trapped in a mode of bloggorial (bloggitic? bloggorian? blogoleptic?) stasis, just going around and around inside my head about all the things I could write about chronic fatigue syndrome, that I would write, as soon as the chance presented itself.

I've finally come to the conclusion (inevitable, obvious, yet heretofore somehow elusive) that it ain't going to happen, and I need to move on. I'm also relieved that the current exacerbation seems to be letting up (these things are much shorter-duration for me these days, thank goodness) and making it more possible to write about other things. One day, I'll take the chance to sit and write at length about chronic fatigue, and craft it into a real essay, and post in on Rosie, Long Form. But for now, I miss writing funny pathetic, and I'm going to start doing it again, dammit.

Which is to say, hi, I'm back, didja miss me?

Monday, May 02, 2005

That's the Spirit

Cassie pooped in the potty! Voluntarily! Yesterday. Peeing in the potty has been happening before bath every night for a while now, but for a long time, pooping was just for the diaper, and the two times she sort of inadvertently ended pooping in the potty, it kind of freaked her out. She still really doesn't want to be bothered with interrupting her activities in any way in the middle of the day for something as tedious as going into a different room and disrobing in order to relieve herself, but at least we're now getting to bracket the day with morning and evening successful potty sessions. I've been resisting, but maybe it's time to break out the bribes. Sigh. Someone suggested having a beloved book that only gets to be read on the potty--maybe that's a good thing to try first.

Anyway. Cassie and I went to the art museum again on Saturday, just the two of us. I ended up having to change her diaper, and we stood in line and waited for the handicapped stall in the ladies' room so that I'd have enough room (she refuses to lie on those changing stations--she feels like she's going to fall, so I have to change her standing up--suboptimal for a poopy diaper, to say the least). I got her all clean and fresh and then decided what the heck, I'll take the opportunity to pee also. While I was on the toilet, Cassie got curious and got down on her hands and knees and started looking into the next stall. I stopped her: "Um, sweetie, please stand up. We don't look at people when they're on the toilet. People need privacy when they're peeing and pooping. Well, not mama and daddy, but definitely people we don't know."

Cassie replied, "But I know everybody!"